Question: Dear Doc,
Pardon me for the long post, but I feel the need to share whats going on. I'm about 42 yrs old, male. Due to work constraints, I have been away from my family for almost 18 months now, and hence very stressed out and depressed. Also, there is very little sunshine exposure for most of the year in this place, and hence taking extra Vitamin D and B12 supplements to compensate.
For the last ten months, i've had recurring symptoms of frequent urination, quite more than the normal. There were no other symptoms prior to this or coupled with this.
I've had all urological tests (2 ultrasounds, cystoscopy, cytometry, urine, blood) and a physical exam of my prostate which all have come out normal. Upon request from my chiropractor who has a specialization in neurology, i also had a basic saccral lumbar MRI without contrast. This showed normal results.
To subside my symptoms, my urologist put me on Ditropan & Vesicare which did not have effects even after taking for extended periods. On the other hand, they had side effects with respect to problems in voiding and retention. I was then prescribed Rapaflo which if taken only by itself seemed to help the retention, but caused me a different side effect in terms of causing cramps / pains in my rear, probably it was acting on my relaxing my prostate. Hence, i stopped all medications. I was also asked to just take warm water baths which may relieve some of these symptoms, but hasn't helped much either.
I am asking the question in the neurology forum mainly because all the urological tests did not conclusively say anything. I am worried and anxious if my symptoms are related to any neurological issue or M.S? I heard lack of Vitamin D could trigger M.S ?
Or could stress play a role in this? I don't have a history of any such issues on both sides of my immediate family.
Are there any neurological tests that you would prescribe? Or any medications?
Please help or advise me what to do further, and how to rectify this.
Appreciate your response.
Sincere Thanks XXXXXXX

Dear Doctor,

Thanks for your response. Although it is of some re-assurance, I am anxious because some of the other symptoms that you mentioned above did occur a couple of years ago, and not in the last ten months.

In detail, the following are what i recall:

a) Back in April of 2008, I suddenly experienced mid and low back pain, and underwent a 12 week physical therapy. I was told this was because of my bad posture and stress at work. After the therapy, the pain completely subsided although once in a while, i do get some upper neck pain.

b) Similarly, back in March 2010, I experienced low back pain along with some tingling in the feet and legs, as well as chronic head ache. I took blood tests (where i was mainly tested for levels of aldolase and creatine kinase (CK) as well as regular CBC. Initial tests showed a slightly elevated aldolase and normal CK, but a second test showed all levels to be normal. I also went through a 1 month physical therapy, and I felt fully better. During the same time, i was also told i had a low Vitamin D and was asked to take supplements.

c) Between April 2010 and Nov 2011 (for about 1.5 years), i was fully ok.

d) Nov 2011 - the urinary frequency symptoms started and is till recurring. And yes, the frequency is only during day time, and not in nights.

I just wanted to let you know the history and request your feedback, if any of the above would be a factor.

Sincerely appreciate your help / feedback.

Best Regards XXXXXXX

Thanks for your response.

I am anxious because one urologist whom i consulted (in the US) and who did all the tests seemed to be the opinion that he could not determine any organic cause for my symptoms (of either recurring frequency or retention), BUT the other urologist (in India) thought there may be some organic cause (i.e; its not a functional but a structural problem). But whatever medications they prescribed (based on their individual observations) did not seem to work.

Would you recommend any specific medications or any steroids that would help subside these OR any Ayurvedic or non invasive methods? Or do you feel stress management or some exercises can help?

Just as an FYI, I am also taking Vitamin B12 supplements as well, which was recommended by my PCP, when back in 2005 i was told i was deficient in it. Does this help for other issues?

Kindly advise.

Thanks much XXXXXXX

Kindly advise.

Hi Doc,

Thanks again.
Please advise if any more testing is warranted based on what's happened so far w.r.t. my symptoms and current condition?

Regards XXXXXXX

Dear Doc,

Thanks for your responses. I just want to find out since i had many tests in the last 1 year or so - which includes Basic Metabolic Panel, CBC, cystoscopy, physical exam of prostate, and cytometry flow testing, how often should i get tested myself given my age? Like the basic BMP and CBC needs to be done every few years or so? Also, what other general physical tests do your recommend apart from above?

Please advise.

Kind Regards XXXXXXX